Effect of the “Art Coloring” Online Coloring Game on Subjective Well-Being Increase and Anxiety Reduction During the COVID-19 Pandemic: Development and Evaluation

Abstract

Background COVID-19 has spread worldwide and generated tremendous stress on human beings. Unfortunately, it is often hard for distressed individuals to access mental health services under conditions of restricted movement or even lockdown. Objective The study first aims to develop an online digital intervention package based on a commercially released coloring game. The second aim is to test the effectiveness of difference intervention packages for players to increase subjective well-being (SWB) and reduce anxiety during the pandemic. Methods An evidence-based coloring intervention package was developed and uploaded to an online coloring game covering almost 1.5 million players worldwide in January 2021. Players worldwide participated to color either 4 rounds of images characterized by awe, pink, nature, and blue or 4 rounds of irrelevant images. Participants' SWB and anxiety and the perceived effectiveness of the game in reducing anxiety (subjective effectiveness [SE]) were assessed 1 week before the intervention (T1), after the participants completed pictures in each round (T2-T5), and after the intervention (T6). Independent 2-tailed t tests were conducted to examine the general intervention (GI) effect and the intervention effect of each round. Univariate analysis was used to examine whether these outcome variables were influenced by the number of rounds completed. Results In total, 1390 players worldwide responded and completed at least 1 assessment. Overall, the GI group showed a statistical significantly greater increase in SWB than the general control (GC) group (N=164, t162=3.59, Cohen d=0.59, 95% CI 0.36-1.24, P<.001). Compared to the control group, the best effectiveness of the intervention group was seen in the awe round, in which the increase in SWB was significant (N=171, t169=2.51, Cohen d=0.39, 95% CI 0.10-0.82, P=.01), and players who colored all 4 pictures had nearly significant improvements in SWB (N=171, F4,170=2.34, partial ŋ2=0.053, P=.06) and a significant decrease in anxiety (N=171, F4,170=3.39, partial ŋ2=0.075, P=.01). Conclusions These data indicate the effectiveness of online psychological interventions, such as coloring games, for mental health in the specific period. They also show the feasibility of applying existing commercial games embedded with scientific psychological interventions that can fill the gap in mental crises and services for a wider group of people during the pandemic. The results would inspire innovations to prevent the psychological problems caused by public emergencies and encourage more games, especially the most popular ones, to take more positive action for the common crises of humankind.

The effect of mindfulness intervention on internet negative news perception and processing: An implicit and explicit approach

“…Moreover, due to experimental methods and challenging differential attrition in the real-state psychological intervention (Graham and Donaldson, 1993), the external ecological validity of this study remained limited in explaining issues at the media and society levels. Meanwhile, second-generation interventions such as mandala art coloring games and loving-kindness meditation were as well proved to be effective (Liu et al, 2019;Xi et al, 2022) in mindfulness and anxiety reduction. Thus, the MBSR training paradigms need to improve in this permanentonline media society and post-truth infodemic communication environment.…”

“…Mindfulness usually refers to a training process of non-judgmental presentmoment experience (Kabat-Zinn, 1990;Bishop et al, 2004), with open-minded acceptance of conscious thoughts, bodily feelings, and the environment (Hofmann et al, 2010;Poon and Jiang, 2020). High mindfulness is positively related to attention focus and reallocation (Lindsay and Creswell, 2017), stress alleviation and reduction (Grossman et al, 2004;Goldin and Gross, 2010;Xi et al, 2022), positive emotions and attitudes (Brown and Ryan, 2003;Hülsheger et al, 2013;Liu et al, 2022a), as well as subjective wellbeing (Brown and Ryan, 2003;Wallace and Shapiro, 2006;Liu et al, 2020Liu et al, , 2022b. The training breaks cognitive barriers, cultivate emotion regulation and satisfaction, copes with mental fatigue, and exalts current beliefs and future expectations (Langer, 2000;Hülsheger et al, 2013;Karelaia and Reb, 2015;Wang et al, 2019;Kudesia et al, 2022).…”

NutriColoring: designing a doodling toolkit to support daily self-reported dietary assessment among office workers

“…On the other hand, color plays a vital role in the food industry in triggering purchasing behaviors and creating important expectations regarding the flavor and visual appeal of food ( Spence, 2016 ; Stich, 2016 ). Previous studies suggested that self-reporting via the coloring approach should not only focus on reducing negative affect (e.g., behavioral and physiological anxiety) but also should set out to investigate potential health-related perspectives (e.g., sedentary lifestyle and healthy eating) through personalization and customization ( Ashlock et al, 2018 ; Burton and Baxter, 2019 ; Xi et al, 2022 ). According to Piqueras-Fiszman and Spence (2014) , altering the color aspects related to food (e.g., the color of plateware/container and packaging; color of the context where foods are eaten) can modify people’s perception and motivation to choose healthy foods.…”

“…Various modalities for Doodling tools designed to enhance the engagement of self-reporting have been studied extensively. Evidence indicates that the Doodling with coloring approach should set out to investigate potential health-related activities ( Ashlock et al, 2018 ; Burton and Baxter, 2019 ; Xi et al, 2022 ) because using colors to visualize nutrition information could be an effective technique for increasing positive understanding of daily food intake ( Ursell, 2007 ). For instance, Deanna ( Minich, 2019 ) pointed out that the concept of Eat a rainbow (i.e., group fruits and vegetables according to their natural colors; people should consume each hue of fruits and vegetables to acquire a range of various vitamins and nutrients that can prevent eating-related diseases) helps people readily relate to the health properties of healthy intake (i.e., fruits and vegetables) and develop a strong sense of self-awareness through colors ( Heber, 2004 ).…”

“…For instance, Deanna ( Minich, 2019 ) pointed out that the concept of Eat a rainbow (i.e., group fruits and vegetables according to their natural colors; people should consume each hue of fruits and vegetables to acquire a range of various vitamins and nutrients that can prevent eating-related diseases) helps people readily relate to the health properties of healthy intake (i.e., fruits and vegetables) and develop a strong sense of self-awareness through colors ( Heber, 2004 ). However, Doodling via coloring approach was mostly explored for self-reporting behavioral and physiological anxiety ( Ashlock et al, 2018 ; Burton and Baxter, 2019 ; Xi et al, 2022 ). In-depth studies directly examining how office workers perceive Doodling with coloring approach and react to its use in daily working context are limited ( Elsden et al, 2016 ).…”